Daring to confront

Have you ever felt guilty for taking a stand against challenging behavior? If you have, you’re not alone. It’s certainly easier to delay confrontation than it is to decide, “Enough is enough,” and take action. Far too often, we allow wrong behavior to continue until an eruption occurs that could have been avoided had we dared to confront.

In an earlier post, I told you about confronting, as a nursing student, a physician who used finger-snapping as a means of communicating with nurses. Well, guess what? Years later, history repeated itself. By that time, I was a charge nurse, and I couldn’t believe I was, once again, witnessing a physician snap his fingers to get the attention of nurses. It was déjà vu all over again.

I still recall the outrage of the nurses. “He shows no respect for nursing staff,” some of them complained, but no one dared confront the physician about his behavior. The situation was delicate. After all, he was a surgeon who commanded power in that hospital. Colleagues said, “Never cross him. You’ll get fired!”

It was déjà vu all over again! 

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Hearing those comments gave me pause, but I didn’t want to see nurses treated with disrespect. Usually, I didn’t have contact with this surgeon unless he wanted to complain that a nurse wasn’t moving fast enough. Another issue was that he would take all the charts, thereby creating problems for nurses who were trying to complete their charting in a timely manner.

Because politics and institutional power were involved, confronting this physician would not be easy, but I knew my nurse colleagues, who were fed up with his behavior and were losing morale, expected me to take action. After pondering what to do, I came up with a plan. The intervention would be simple. To force the physician to interact with me, all the other nurses would be with patients in their rooms.

Like clockwork, he came to the floor the next day to complete his rounds, this time accompanied by residents, and, as usual, the finger-snapping began. I intentionally ignored him. The snapping continued, but I remained silent. Growing frustrated, he finally blurted out, “Don’t you hear me talking to you?” He was speaking loud enough that the other nurses came out of the patients’ rooms, and the residents stood aghast. This was my opportunity.

Walking over to him, I said, “Hello, Doctor. My name is Chris. I am the charge nurse, and I have a simple request. Do not feel you need to snap your fingers to get my attention. I prefer that you address me as Chris. Also, I was wondering if we could agree on a time for you to chart so my nurses could have the charts back in time to complete their documentation?”

To my surprise, he responded, “No problem, Chris. We certainly do not want to increase the hospital’s budget,” and he chuckled. The residents stood with their mouths open. From that day forward, he never tried to get a nurse’s attention on that unit by snapping his fingers, and, yes, we were able to arrange for a suitable time for him to review charts.

Every nurse asked me, “How did you do that? I cannot believe his response.” The only insight I had to share was that, as a student, I had learned to assert myself and not allow a physician to treat me as an object—to objectify me—and my refusal to let him do so disrupted his improper behavior. Nurses do have power when we affirm our role and identity.

I knew that both the physician and I shared a desire for our patients to heal, and, to make that happen, we needed to function as a team. From that time forward, he would say, “Chris, how are my patients doing today?” I realize that communication challenges are complex, and confronting doesn’t always turn out as well as this encounter did, but the surgeon and I both discovered that a simple introduction that began with “Hi, my name is Chris” can stop disrespectful communication in its tracks and lead to positive outcomes.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

I wouldn't change a thing!

One aspect I love about the profession of nursing is the tremendous opportunity it offers to pursue various career paths. My students often ask how I ended up in academia and, if I could do things over again, would I have done something different. My answer is always the same: “No, I would not have changed a thing. I believe we are called to fulfill a purpose on this planet, and nursing has allowed me to make good on the commitment I made to my grandmother to be a force of healing in the world.”

Like many of you, I have worked in a variety of areas, but feel a profound sense of gratitude working in academia. As academicians, we are charged with the great responsibility of shaping future nurses—clinicians, scientists, educators—for a profession endowed with a plethora of opportunities. Whether in the hospital, community, or academic setting, our common bond is that we are nurses. All of us contribute in unique ways to ensure that we have a competent workforce for an ever-changing landscape. I do not know where my students will end up, but one thing for sure: By becoming members of the most trusted profession on this planet, they will use their talents and compassion to improve the lives of many.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Touching lives

The other day I was looking at photos from my college days, and came across one of my nursing classmates and me. The picture stirred memories of one of my favorite professors, truly a role model of what nursing is all about. I recalled how she walked with such purpose and deliberation. I remembered enjoying her visits with me as I provided care to patients and how much I wanted, like her, to inspire and motivate them.

She believed nurses are charged with the responsibility of touching every life they encounter, whether in the hospital or community. Everywhere we go, she taught us, we should remember that we represent a noble profession that should never be dishonored by unkind behavior toward another; that we are being watched by patients, families, and friends; and that we truly never know how many lives we touch on a daily basis.

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We all have cared for patients who may not have been kind to us during our interaction with them, which could have negatively influenced our perspectives about them. Interestingly, one of my colleagues shared a story about how a discharged patient returned with a beautifully written note, thanking the nurses for changing his life. The staff was shocked, because no one believed the patient regarded any of them positively. Listening to her story took me back to the principle my former professor instilled in me about showing unconditional regard toward patients, colleagues, friends, and families. Doing so provides nurses with a platform from which they can inspire all with whom they interact.

Touching lives. Isn’t that what nursing is all about?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those the promote products or services will not be posted.

Mental illness is not a dirty word!

Have you ever felt embarrassed about seeking out counseling or therapy? Or were uncomfortable about sharing with friends or family that you needed mental health support? I have worked in the mental health field for a number of years and remain concerned about the persisting stigma toward those seeking mental health treatment. I also wonder how many people suffer in silence due to the fear of disclosing that they need such treatment.

As nurses, we invest a great deal of time educating individuals to get yearly physical health screening, but how often do health providers ask about our mental health during those yearly exams? We have all witnessed tragedies across this nation that result from lack of mental health interventions. There is no question that ignoring symptoms of mental distress is not wise and usually results in poor outcomes.

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Without question, nurses, through daily encounters with patients in both in- and outpatient settings, are well positioned to address the mental health of those patients. Each year, thousands of students across the United States are trained in the art and science of psychiatric nursing. We emphasize the importance of developing a therapeutic relationship with clients and understanding the origin and treatment of mental health problems. Additionally, students are made aware of the impact of stigma on individuals who experience mental distress. So, nursing has an effective platform from which to address mental health issues.

Strategically, it would be great if more RNs specializing in mental health were present in larger numbers in educational settings from kindergarten through college, because early prevention is an effective approach for detecting and treating symptoms of mental illness. Just as we promote yearly screening for diabetes, hypertension, and high cholesterol, we should invest the same energy in screening for mental illness. Each of us should commit today to encouraging friends, families, and colleagues to seek out yearly mental health screenings.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Pass the torch!

I am constantly amazed at the opportunities I have to mentor another male into considering nursing. I take great pleasure in sharing with others how choosing a career in nursing was one of the best decisions I made as a young person.

One day, as I sat in my office, a young man happened by and stopped to ask if he could speak to me about men in nursing. You don’t need to guess what I did. I motioned him inside my office and sat him down. His face beamed as I shared stories about my days as a student, as well interesting clinical cases I had encountered throughout my career. I was thrilled by the numerous questions he posed. I could feel his passion for making a difference, and I thought to myself, “Yes, this young man will make a fantastic nurse.” As he left, I knew our chance encounter was just that, because I had not planned on being in the office that day.

As I reflect, I am glad I was there and, more importantly, that I had the opportunity to meet this wonderful young man, who is clearly on his way to becoming a nurse. You know, so often we get busy and do not take the time to talk to prospective students, or we are simply too overwhelmed by all that is expected of us and unintentionally make ourselves unavailable.

I remember learning from a wise professor a long time ago to always leave my door open, both literally and figuratively, because we never know who may come knocking. Looking back, I say my professor was right. After all, it was a chance encounter that influenced me to choose nursing. The individual was an ER nurse who told me to “hold to my dream,” that I would end up doing what I was meant to do. All I can say is, I will continue passing the torch, and I think you should do the same.

For Reflections on Nursing Leadership (RNL), published for the Honor Society of Nursing, Sigma Theta Tau International.

Focus on your legacy, not the footnotes!

Have you ever wondered why mentors or colleagues betray you or do things they know are detrimental to your career? Ever since I can remember, I have pondered this phenomenon. I recall expending a lot of energy trying to understand their motives—in other words, the “why" question. It took me a long time to make peace with the fact that, no matter how much you revere a nurse or how kind a colleague is to your face, he or she can betray you in a second in the worst way.

Like you, I have heard countless stories of how malicious gossip, spread by those with an appetite for cynicism, has damaged a nurse’s reputation The lesson I had to learn was to separate the person’s actions from the noble profession of nursing.

When I decided to become a nurse, it was more than a career decision. It was a choice motivated, in part, by an internal sense that my call to nursing was to heal and help others live a life of quality and, more importantly, integrity. I have been privileged during my life’s journey to know inspiring individuals who happen to be nurses. They are people I can trust and turn to for advice and wise counsel. Unfortunately, as with some of you, I have also experienced betrayal and often wondered how we advance our profession by hurting other nurses.

Well, through the years, I have ceased asking myself that question and, instead, decided to focus on the legacy I want to leave. In trying to fix nurses who engage in destructive behaviors, we eventually lose our selves and our purpose.

So, here is my advice. No matter how tempting it is to seek revenge, don’t. Instead, focus on what brought you to nursing, and resolve to be a healing rather than a destructive force. Smile, because when your life journey ends, you will be remembered for the investment you made in improving people’s lives. More importantly, the legacy of your nursing career will outlive any negative footnotes created about you by those who have sadly lost sight of the core values of our noble profession.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Cracking the glass ceiling

In my travels, I have had the opportunity to speak to a number of male nursing students who underscored the need for men in nursing to pursue leadership. While some nurse leaders dismiss the significance of the gender gap, it has a profound impact on how men progress in the profession. Seeing nurses, who are male, in leadership roles provides inspiration to budding clinicians and scholars. Additionally, it sends an important tangible message that, with hard work and perseverance, men can carve their path in a female-dominated profession. For men who enter schools of nursing or are employed at hospitals that lack gender diversity, it is not as easy as it may seem.

I recall one of my female colleagues in medicine sharing how she attended a conference where she was the only female on a panel. I could feel her angst as she described her discomfort. Reflecting upon our conversation made me realize nursing’s moral obligation to develop pathways that increase the number of men at the bedside as well as at the administrative level. There is no doubt in my mind that men in nursing still experience marginalization. However, I am encouraged by initiatives promulgated by the American Association of Colleges of Nursing (AACN) and others to diversify the profession by gender.

To dispel myths that, unfortunately, are still pervasive, it is essential that men be visible at the bedside and at academic and administrative levels. The transition has begun, and I am thrilled. I charge all schools of nursing to not only think about recruitment, but also consider developing clinical and administrative pathways that allow men to continue cracking the glass ceiling.

Photo credit: Comstock Images/Thinkstock
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

It takes a real man to be a nurse!

I have served as faculty adviser to the Male Association of Nursing at the University of Pennsylvania (MAN-UP) for five years, and these young men inspire me by their leadership. The concept of MAN-UP is simple: “Be leaders, be mentors, and serve your community.” What more could we ask of our nursing students?

Since its inception, MAN-UP has provided an important voice for male nursing students, and has developed and implemented successful programs targeting men’s health. In particular, the students recruited an NFL athlete, who spoke about the importance of men receiving yearly physical exams, and a noted author, who shared how to navigate tall mountains.

Soon after MAN-UP was formed, the concept caught fire, and I began to receive calls from nursing schools all over the United States, as well as Canada, inquiring how to start a male student nursing association. I was moved by their interest, because it validated the importance of our group in recruiting qualified male students and addressing men’s health issues. As a result, MAN-UP has mentored other nursing schools on starting their own male nursing associations.

MAN-UP has been featured in media outlets for its campus-wide work. Specifically, we hosted the first men’s mental program, focusing on campus suicides, symptoms of depression and providing depression screenings to all interested students. In recognition of the organization’s work, the University of Pennsylvania School of Nursing has twice been awarded the prestigious “Best School in Nursing” award by American Assembly for Men in Nursing.

These are our future nursing leaders, and their compassion to help their peers and serve their community epitomizes what nursing is all about—being leaders, being mentors and serving the community. This is why I am inspired.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing.

Snap to it, nurses!

The other day, a colleague and I were commiserating on challenges encountered during our time as nursing students. We had some tough times, we agreed, but had to admit there were nurses who were terrific role models and simply unforgettable. As we reminisced, I shared an experience I had as a senior nursing student during a clinical rotation on a telemetry unit.

The culture on the unit was that, when a physician came to the floor, the nurses were expected to give up their seats and clear the nursing station. I had witnessed this numerous times and thought it was not only silly but also demeaning to our profession. I could not figure out why the nurses were so afraid to continue their charting or stay in their seats, and I decided it was time for action. I intentionally did not tell my classmates about my plan, because I feared it might get back to my clinical instructor. Nevertheless, I believed it was the right thing to do.

The next morning, after I had completed a.m. care and administered medications, I was standing near my patient’s door, looking over my notes, when I heard one of the nurses say, “Here he comes!” As I watched them clear the area, I thought, “How could they leave me standing here alone?” and my heart started racing. This particular physician was known for snapping his fingers to get your attention, or if he wanted you to follow him into a patient’s room. As he approached, I watched out of the corner of my eye. In typical fashion, he did not speak as he began poring through the charts, but a moment later, I felt him staring at me.

Then it happened. Snap, snap, snap went his fingers, and I vividly recall feeling fright, and a compulsion to flight. After all, I was a student. I heard it again: Snap, snap, snap! “Didn’t you hear me call you?” he asked.

I cannot tell you from where I mustered the courage but, having seen enough, I responded, “Yes, I heard you snapping your fingers, but let me introduce myself. My name is Chris, and I am a senior nursing student.” Looking quite stunned, he said, “Well, Chris, could you give me an update on Patient X?” and I said, “Sure.” Upon leaving, he patted me on the back, and smiled.

What happened the following day was even more remarkable. When he came back to the unit, he said, “Hello, Chris. Want to go on rounds with me?” Everyone looked shocked! For the moment, finger snapping was history, and I began to see a gradual shift toward more assertive behavior from the nurses. So you see, Gandhi had it right. The best course of action is to “be the change you wish to see.”

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Nursing fundamentals: A lesson in persistence

Do you have a professor or instructor who left an indelible footprint that shaped the trajectory of your nursing journey? As you ponder, let me tell you about my fundamentals of nursing instructor who introduced me to the proper method for making a bed. I will call her Mary. She was a business-like instructor who operated with precision in the lab.

For you nurses, remember how we had to learn to change both an occupied and unoccupied bed? As I write this, I recall my trepidation, because I both feared and admired Mary. Besides my mom, she was the first woman to reinforce for me the seriousness of bed-making. However, she went further. She stipulated, “Do it in less than five minutes!” and she strictly adhered to that time frame.

Mary told me I would struggle in nursing if I did not master the art of making a bed in less than five minutes. Well, I was determined to master this skill, and Mary, who took a liking to me, kept me in the lab until I had perfected it, and I did. I must admit, I struggled to understand her obsession with quickly making a bed. However, as I grew older, I had an epiphany. Yes, the bed-making was important but, more importantly, Mary taught me the art of elegant persistence in every aspect of nursing practice. Who would have thought a remedial lesson on bed-making would later serve a larger purpose, to remind me it is persistence that exemplifies the elegance of nursing practice?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.